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Illinois rates for HCPCS A9604

Samarium Sm-153 lexidronam, therapeutic, per treatment dose, up to 150 mCi

Facilitymedian $15,488 · 10th–90th $3,388–$131,8260%10%10th90th$15,488Professionalmedian $16,218 · 10th–90th $15,488–$19,4980%50%10th90th$16,218$50.0$200.0$1.0K$5.0K$20.0K$100.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,388.44 / $15,488.17 / $58,884.37
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15,488.17 / $15,848.93 / $19,498.45
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,981.07 / $72,443.60 / $223,872.11
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$23,442.29 / $33,113.11 / $39,810.72
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16,595.87 / $16,595.87 / $16,595.87
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $199.53 / $13,182.57
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $39.81
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,162.28 / $7,079.46
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16,218.10 / $16,218.10 / $17,782.79